ATI RN
ATI Pediatric Proctored Exam 2023
1. The nurse is unsuccessful in inserting a nasogastric tube for a newborn client. The nurse suspects the newborn has esophageal atresia/tracheoesophageal (EA/TE) fistula. Which nursing action is appropriate while waiting for the healthcare provider to further assess the neonate?
- A. Position the newborn in a semi-Fowler position.
- B. Allow the newborn to stay in the nursery for observation.
- C. Offer the newborn pacifier for comfort.
- D. Wrap the newborn in blankets and place in an incubator.
Correct answer: A
Rationale: Positioning the newborn in a semi-Fowler position is appropriate as it helps prevent aspiration in suspected EA/TE fistula. This position helps reduce the risk of regurgitation and aspiration of gastric contents. Placing the newborn in a semi-Fowler position promotes the drainage of secretions and reduces the risk of complications while awaiting further assessment by the healthcare provider.
2. The patient is receiving a heparin infusion for the treatment of pulmonary embolism. Which assessment finding is most likely related to an adverse effect of heparin?
- A. HR of 60 bpm
- B. BP of 160/88
- C. Discolored urine
- D. Inspiratory wheezing
Correct answer: C
Rationale: The primary and most serious adverse effect of heparin is bleeding. However, discolored urine can indicate bleeding into the urinary tract, which is a potential adverse effect of heparin therapy. While changes in heart rate (HR) and blood pressure (BP) can occur due to various reasons, discolored urine specifically points towards a potential adverse effect related to heparin therapy.
3. A pediatric client is admitted to the emergency department with a traumatic brain injury (TBI) that caused a loss of consciousness. The last set of vital signs showed heart rate 48, blood pressure (BP) 148/74 mmHg, respiratory rate 28 and irregular. What does the nurse suspect based on these data?
- A. Spinal cord injury
- B. Increased intracranial pressure
- C. Typical for sleep
- D. Improvement
Correct answer: B
Rationale: The vital signs of bradycardia, hypertension, and irregular respirations indicate increased intracranial pressure. Bradycardia (heart rate of 48), hypertension (blood pressure of 148/74 mmHg), and irregular respirations are typical signs of increased intracranial pressure in a pediatric client with a traumatic brain injury and loss of consciousness.
4. A newborn diagnosed with an omphalocele defect is admitted to the intensive care nursery. Which nursing action is appropriate based on the current data?
- A. Placing the newborn on a radiant warmer
- B. Placing the newborn in an open crib
- C. Preparing the newborn for phototherapy
- D. Preparing the newborn for bottle-feeding
Correct answer: A
Rationale: Placing the newborn on a radiant warmer is appropriate as it helps maintain the body temperature and prevent hypothermia in a newborn with an omphalocele defect. This is crucial for the infant's well-being and supports their physiological stability.
5. Why is the specific gravity for infants lower than for older children?
- A. Infants have a greater body surface area.
- B. Infants have a higher basal metabolic rate.
- C. Infants have a greater percentage of body weight that is water.
- D. Infants' kidneys are less able to concentrate urine.
Correct answer: D
Rationale: The correct answer is D because infants' kidneys are less developed compared to older children, making them less efficient at concentrating urine. This results in a lower specific gravity in infants. The other choices do not directly explain why the specific gravity is lower in infants.
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